How the MISSION Act Expands Treatment Access for Veterans


As a veteran or loved one of a vet, you may have heard of the MISSION Act and are unsure of what it is or how it impacts veterans or their caregivers.

The MISSION Act expands options for veterans and makes numerous changes to improve the veteran care experience.1 The Act:1

  • Gives veterans greater access to community care.
  • Makes it possible for veterans to access urgent care with the VA.
  • Authorizes telehealth to enable veterans to access care remotely across state lines.
  • Helps the VA to find and retain quality clinicians.

Here you’ll learn what you need to know about the MISSION Act, community care, and how veterans can use the MISSION Act to get treatment outside of the VA when necessary.

Did the MISSION Act End Veterans Choice? 

Yes. The Veterans Choice Program, or VCP, ended in June of 2019.2 This means the VA is not using the VCP to give veterans access to community care. However, this does NOT mean that community care has ended.1

Veterans will now use the new Veterans Community Care program to utilize private facilities or other treatment providers in the community when they cannot use a VA program.1

What Is Community Care for Veterans?

veteran talking to therapistVeterans will generally receive the treatment they need from the VA, but there are some cases when this is not possible such as when there are no facilities close by or the wait times are too long. 1

In cases like these, the VA may allow the vet to receive care from a community provider.3 These are private treatment providers authorized by the VA to treat veterans when the VA is unable to do so.

In order to access community care, a veteran will need to meet certain eligibility requirements, outlined below.

VA Community Care Eligibility

There are 6 eligibility criteria for community care, and a veteran only needs to meet one of them to be eligible. 4

As a veteran, you may be able to get treatment with a community provider if:4

  • You need a specific kind of treatment that cannot be provided at a VA facility. An example is maternity care, as this is not provided by the VA.
  • The VA does not have an appropriate facility within an acceptable driving time from you. The driving time is considered unacceptable if it is more than a:
    • 30-min. average driving time for mental health services, primary care services, or extended care services (such as adult day care).
    • 60-min. average driving time for specialty services.
  • The wait time for an appropriate VA facility is considered unacceptable (unless the veteran agrees to a longer wait time in consultation with a VA healthcare provider):
    • More than 20 days for primary care, mental health services, or extended care services.
    • More than 28 days from the date of request for specialty care.
  • It is in your best medical interest to get treatment through a community care provider. The referring clinician must agree that it is in your best interest to go outside the VA for care.
  • A specific VA medical service line for the type of care you need is not currently meeting the VA’s quality standards.
  • You qualify for community care under the “grandfather” provision as it relates to your distance eligibility under the VCP.
    • You were eligible under the 40-mile criterion of the VCP on June 5, 2018, the day before the MISSION Act became law and you still live in a location that meets that criterion.
      AND
    • You live in one of these 5 states: North Dakota, South Dakota, Wyoming, Montana, or Alaska.

Even if you are eligible for community care, you still have the option to receive treatment through the VA if that’s your preference.5

4 Steps for Finding a Community Care Program

If you are a veteran interested in getting treatment through the community care program, there is a simple process to understand:4,5

Step 1: Work with the VA to determine if you qualify for community care. In most cases, you need VA authorization to seek treatment with a community provider.

Step 2: Make an appointment. A VA staff member will usually make an appointment for you with a community care provider, though you may be permitted to make the appointment yourself. You can select the provider yourself or get help from the VA, but the provider must be in the VA’s network of authorized community care providers.

Step 3: Receive treatment from the community care provider.

Step 4: The community care provider you utilized will send the claim to either the VA (or a third-party administrator contracted by the VA) to receive payment.

The VA makes it simple to find a community care provider in their network with their online locator tool.

VA Community Care with American Addiction Centers

Sunrise House’s parent company, American Addiction Centers (AAC), has two facilities that are currently authorized community care providers in the VA’s network, providing substance abuse and mental health treatment to veterans.

AAC has built out a veteran-specific drug abuse and mental health treatment program in two of its facilities in Las Vegas, Nevada and Hollywood, Florida.

The Salute to Recovery program has been designed to address the unique issues that impact the lives of veterans and that perpetuate the cycle of alcoholism, drug abuse and addiction. In the program, veterans are treated alongside other veterans and first responders. Program participants are referred to as “the battalion” and are encouraged to support each other during and after their time in treatment. Many staff members are veterans themselves and can offer an understanding of how military experiences shape the lives of veterans.

For more information about our programs, call us at 973-862-4820. Our Admissions Navigators are here 24/7 to help you understand your treatment options and the process of accessing community care through the VA.

 

References:

  1. U.S. Department of Veterans Affairs. (2019). VA launches new health care options under MISSION Act.
  2. TriWest Healthcare Alliance. (2019). Provider Pulse.
  3. U.S. Department of Veterans Affairs. (2020). Community Care Overview.
  4. U.S. Department of Veterans Affairs. (2019). Community Care.
  5. U.S. Department of Veterans Affairs. (2019). Veteran Community Care Eligibility.


About The Contributor

Laura Close
Laura Close

Senior Web Content Editor, American Addiction Centers

Laura Close is a Senior Web Content Editor at American Addiction Centers and an addiction content expert for Oxford Treatment Center. She has a bachelor’s degree in English and has nearly a decade in professional editing experience that includes... Read More


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